PLA喉罩在腹腔镜子宫切除手术中的临床应用.docVIP

OPLAC喉罩在腹腔镜子宫切除手术中的临床应用 山东省临沂市沂水中心医院麻醉科276400 】目的评估OPLAC喉罩在腹腔镜子宫切除手术麻醉中的应用效果，并 探讨其安全性和有效性。方法随机将全身麻醉下腹腔镜行子宫切除术的子宫肌 瘤患者80例，分为两组：OPLAC喉罩组（L组）和气管插管组（T组）。分别记 录人工气道建立成功时、成功后30min及手术结束时的平均气道压（Pmean）、 气道峰压（Ppeak）、呼气末二氧化碳分压（PetCO2）和患者入室时（T1）、人工 气道建立成功时（T2）、建立后lOmin （T3）、拔管（喉單）前即刻（T4）、拔管 （喉罩）后即刻（T5）的平均动脉压（MAP）、心率（HR）；并观察术中有无反 流误吸情况及术后咽喉部并发症，如声嘶或咽痛等。结果喉罩组和气管插管组 在人工气道建立成功时、成功后30min及手术结束时的Pmean、Ppeak、PetC02 比较，差异均无统计学意义。两组在T1时的MAP和HR比较，差异无统计学意 义；喉罩组在T2?T5时的MAP、HR明显低于同时点的气管插管组，差异均有统 计学意义。两组各时间点SpO2均为100%。喉罩组术中未发现1例反流误吸患 者。两组术后各发生3例轻微咽痛，均未见声音嘶哑。结论全麻OPLAC喉罩通 气用于腹腔镜子宫切除术患者优于气管插管，易于维持血流动力学稳定，应激反 应轻微，全麻后恢复平稳。 关键词】OPLAC喉罩；全身麻醉；腹腔镜子宫切除 Clinical application of OPLAC laryngeal mask in hysterectomy under laparoscopy Yang Mengchen Department of Anesthesiology，Yishui Center Hospital, Linyi of Shan Dong 276400 [AbstractJObjective To assess the safety and efficacy of general anesthesia with OPLACIaryngeal mask in hysterectomy under laparoscopy .Method Eighty patients（ASA I ?Il ）scheduled to undergo hysterectomy under laparoscopy with general anesthesia were randomized into two groups： OPLACIaryngeal mask airway group(group L)and endotracheal intubation group(group T).Pmean, Ppeak and PETCO2 were measured at intubation or laryngeal mask insertion，30 min after intubation or laryngeal mask insertion，after operation in two groups， respectively.MAP and HR were recorded at before anesthesia (Tl)，successful airway placement (T2)，10 min after successful airway placement (T3), before extubation or laryngeal mask removal (T4), after extubation or laryngeal mask removal (T5) in two groups, respectively.Reflex, aspiration and side effects with laryngeal mask insertion including throat soreness，hoarseness，etc were carefully monitored during perioperation.Results Pmean, Ppeak and PETCO2 had no significant difference in two groups at the time of intubation or laryngeal mask insertion was successful，after 30min, and after operation. MAP and HR had no significant difference in two groups at the time of Tl.